Isolated choroid plexus separation on second-trimester sonography: natural history and postnatal importance

This study was undertaken to investigate the natural history and clinical importance of choroid plexus separation (a > or = 3 mm distance between the choroid plexus and medial wall of the lateral ventricle) as an isolated finding in the second trimester.

This was a 5-year retrospective review of an ultrasound database, looking for singleton fetuses with a menstrual age of 16 to 26 weeks and a finding of isolated choroid plexus separation.

There were 78 cases available for study. The finding of choroid plexus separation was usually transient. Resolution was noted in 37% of the cases that were rescanned within 2 weeks and 71% of the cases that were rescanned more than 2 weeks after the initial diagnosis. Two abnormal karyotypes (trisomy 21 and 47,XXY) and 3 cases with abnormal development not associated with an abnormal karyotype were noted on neonatal follow-up. Cases with abnormal development were quite varied in their presentation.

The finding of isolated choroid plexus separation is usually temporary, resolving in most cases within 4 weeks of the initial diagnosis. Most infants with this finding have no abnormalities. The clinical implication of the lone case of trisomy 21 was limited by a major preexisting risk in this patient. The 3 cases of abnormal development had varying presentations; the causal nature of this association is not yet clear. No trends were noted between the changing choroid plexus appearance with time and abnormal neonatal outcome, but the number of abnormal cases was quite limited.